Cities' stake in health law's success

Ruben De La Rosa, center, assist attendees sign up for ACA during an Affordable Care Act enrollment fair held at the University of Texas-Pan American's CESS building saturday, Feb. 1, 2014 in Edinburg, Texas.(AP Photo/The Monitor, Joel Martinez)

News this week from the Associated Press revealed that half of the nation's uninsured live in just 116 counties nationwide, ours among them. In fact, roughly 1 in every 50 uninsured people in the U.S. live just in Harris County, which has the second-highest concentration of uninsured.

Urban areas like ours - Houston and Tampa - face a big challenge. Local communities, not Washington and not our state capitals, are where the impact of big decisions about health care are keenly felt. High concentrations of people with no health coverage threaten the health systems everyone in a city depends on. Having so many uninsured people in one place means more strain on health care providers. On the other hand, getting more people covered is a smart public health strategy.

Under the Affordable Care Act, it's possible for many more people to get insured, including those with pre-existing conditions and those who used to have no coverage option that fit their budget.

But for people to enroll in coverage, they first need to know what's changed and that financial help's available for them and their families. That's where the city and our local nonprofit partners come in.

In Houston, the lack of health insurance is so severe and such a significant problem that our city is implementing an emergency management response system with community-based partners to coordinate enrollment initiatives. We are treating the opportunity to enroll the uninsured the same way we would respond to a natural disaster: with attention and coordination.

We are reaching the uninsured in the places where they already are, meeting people where they live, work, worship and play. Sophisticated data-tracking helps guide the effort, as we work alongside groups with deep ties to our numerous ethnic communities. That way, Houstonians learn from messengers they already know and trust about the new insurance options available to them and the financial help that can help pay for coverage.

For example, right now, residents are finding they can get free assistance with filing their taxes and enrolling in health care at one-stop spots linked to Neighborhood Centers Inc. and Get Covered America. Folks can learn not only about ways to get a bigger tax return this year, but also how to get tax subsidies through the new Health Insurance Marketplace to improve their families' financial security.

Many residents in our cities are still learning about their new coverage choices. In the past, having a pre-existing condition made it hard for many to get coverage, and insurance plans filled with loopholes or tricky fine print made it difficult to shop.

People who didn't have health coverage through their jobs or a public program like Medicare had trouble finding a plan that fit the family budget. Thankfully, that's all changing. As of this year, health insurers can no longer discriminate against people based on a history of illness or injury. Plans are clear and cover all the essentials now, with prescriptions, emergency care, maternity care, mental health care and other basics covered in every new plan.

In both Houston and Tampa, local residents are getting connected to free, in-person assistance with the aid of the city. Consumers are able to get help at local community centers, where they can have their questions answered, shop for health insurance, compare options and actually enroll in health insurance. Also in Tampa, first responders are equipped with valuable information as they travel out in the community helping citizens in need.

Our cities have high uninsured rates, and our states are connecting the most people of any states to their new coverage options in the federal health insurance marketplace.

We want to make sure the marketplace's rocky beginning doesn't overshadow a critical opportunity to get more uninsured people covered, before the open enrollment period ends on March 31.

As mayors, we want to make sure the next few weeks allow as many of our community members as possible to get the coverage and peace of mind that will help make our cities even better places to live.